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Do Nursing Home Chain Size and Proprietary Status Affect Experiences With Care?
Kai You1, Yue Li, Orna Intrator
1*Department of Economics, University at Albany, State University of New York, Albany †Department of Public Health Sciences, Division of Health Policy and Outcomes Research, University of Rochester Medical Center, Rochester, NY ‡Department of Health Policy, Vanderbilt University School of Medicine, Nashville, TN §Department of Health Management and Policy, University of Michigan, Ann Arbor, MI ∥Department of Health Care Policy, Harvard Medical School, Boston, MA.
Nursing home chain ownership impacts patient care experiences. For-profit chains, especially larger ones, are linked to lower family-reported care ratings compared to nonprofit facilities.
Area of Science:
- Healthcare Management
- Quality of Care Research
- Long-Term Care Studies
Background:
- Over half of nursing homes are corporate chains, with concerns about lower quality in large for-profit facilities.
- The relationship between nursing home chain ownership and patient care experiences remains understudied.
Purpose of the Study:
- To investigate the association between nursing home chain characteristics (size and profit status) and family-reported experiences with care.
- To analyze how chain affiliation influences consumer ratings of nursing home quality.
Main Methods:
- Utilized Maryland nursing home care experience reports and Online Survey, Certification, And Reporting (OSCAR) data (2007-2010).
- Assessed consumer ratings across multiple domains including overall care, staff performance, and autonomy.
- Employed multivariate random effect linear models to evaluate the impact of chain ownership on reported care experiences.
Main Results:
- Independent nonprofit nursing homes received the highest overall ratings (8.9).
- Facilities in for-profit chains, particularly small (8.2), medium (7.9), and large (8.0), reported lower overall ratings.
- Similar disparities were observed in recommendation rates, staff communication, and quality of care ratings.
Conclusions:
- Nursing homes affiliated with medium and large for-profit chains show lower family-reported experience ratings.
- Chain ownership structure is a significant factor influencing the perceived quality of care in nursing homes.
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